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Hypertension in Children and Teens & How to Prevent Future Risks

A blood pressure test is a standard part of any well-check, whether you’re 3 years old or 100. While we usually think of high blood pressure – also known as hypertension – as an adult issue, children from birth to young adults can have it too.

According to the American Academy of Pediatrics, it’s estimated that 3.5 percent of all children and teens in the U.S. have high blood pressure. However, like many adults, their condition often goes undetected and untreated.

“Hypertension, or high blood pressure, was regarded as a disease of adults for several decades,” said Ayah Elmaghrabi, MD, a pediatric nephrologist at Banner Children's Specialists Pediatric Surgery Clinic in Mesa, AZ. “However, since the release of the first report by the Task Force on Blood Pressure Control in Children (in 1977) there’s been increased attention brought to the risks of high blood pressure in children.”

What can cause high blood pressure in children?

There are many reasons that a child may have high blood pressure. “Hypertension in children can be primary or secondary to other diseases,” Dr. Elmaghrabi said.

Primary hypertension means there is no obvious cause for high blood pressure. However, according to Dr. Elmaghrabi, primary hypertension is mostly related to elevated body mass index (BMI) and is increasing in tandem with being overweight and obese among children. Children with obesity are at a much greater risk for hypertension than children without obesity.

In addition to being overweight and obese, there are a variety of hereditary and lifestyle related factors that can contribute, including:

Secondary hypertension can be related to an illness, certain medications or a medical condition, such as diabetes, kidney disease, thyroid disease or heart disease. “Secondary hypertension is more common in children than adults, with kidney disease being the leading cause,” Dr. Elmaghrabi said. “It can also be caused by abnormal hormone levels, heart and vascular diseases, medications, tumors and rare genetic mutations.”

What do the blood pressure numbers mean?

Blood pressure readings have two numbers. The top number, or the systolic pressure, tells you about the pressure in your arteries when your heart beats. The bottom number, or the diastolic pressure, tells you the pressure of your arteries between each heartbeat.

Normal blood pressure in kids depends on their gender, age and height. Your child’s doctor uses this information to determine if your child has healthy blood pressure for their height, age and gender. Children who fall above the 90th percentile are considered to have elevated blood pressure; those who are above the 95th percentile have high blood pressure or hypertension.

You can use the Baylor College of Medicine’s calculator to see if your child’s blood pressure reading is in a healthy range.

How is hypertension diagnosed in children?

Hypertension is often a silent condition. Typically, there aren’t any visible signs to tip you off that your child has high blood pressure. And, in many cases, it seems to develop with age.

Some children with hypertension may experience frequent headaches, changes in vision or dizziness that can lead to a diagnosis by their doctor, but most often it’s discovered during well-checks when a blood pressure test is done. Your child’s blood pressure is considered high if the blood pressure percentile continually falls above the 95th percentile on three separate visits.

How is hypertension treated in children?

“Hypertension in children is treated according to the underlying cause,” Dr. Elmaghrabi said. “Lifestyle changes are the main therapy for primary hypertension, but medication might be needed for primary as well as secondary hypertension.”

If your child is diagnosed with hypertension, the number one course of treatment is lowering their blood pressure. This is often done through lifestyle changes, which may include losing weight, exercising regularly and eating a healthier, low-sodium diet.

Here are some tips for feeding the family healthy meals:

If needed, your child’s doctor may also prescribe medications to help control their blood pressure. These are the same medications adults take but they’re adjusted for age and weight and can be given both short- and long-term.

What things can we do to prevent high blood pressure?

In addition to maintaining a healthy diet – one full of vegetables, fruits, lean proteins and whole grains – here are some tips to help your child keep a healthy weight and normal blood pressure:

“Early diagnosis and treatment of hypertension in children are crucial to preventing serious complications, such as stroke and heart disease,” Dr. Elmaghrabi said. “And prevention of primary hypertension by addressing obesity is exceedingly important.”

Find a doctor

If your child is showing signs of hypertension or you have concerns about their health, contact one of our Banner Health pediatric specialists at bannerhealth.com.

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